Chronic Obstructive Pulmonary Disease (COPD): The Daily PANCE Blueprint

Home Chronic Obstructive Pulmonary Disease (COPD): The Daily PANCE Blueprint

Chronic Obstructive Pulmonary Disease (COPD): The Daily PANCE Blueprint

A 64-year-old man with a 40-pack-year smoking history reports years of progressive exertional dyspnea and a chronic productive cough. Exam shows a prolonged expiratory phase, diffuse wheezes, and a barrel-shaped chest. Which is the most appropriate test to confirm the diagnosis?

A. Chest radiograph
B. Post-bronchodilator spirometry
C. Arterial blood gas
D. High-resolution CT of the chest
E. Diffusing capacity (DLCO)

Answer and topic summary

The answer is B. Post-bronchodilator spirometry.

COPD is confirmed by post-bronchodilator spirometry showing a fixed FEV1/FVC ratio < 0.70 (GOLD 2025) — airflow obstruction that does not fully reverse, which is the key feature that separates it from asthma. A chest radiograph or CT may show hyperinflation or emphysema but cannot confirm obstruction; an arterial blood gas reflects gas exchange and severity, not the diagnosis; and a reduced DLCO supports emphysema but is not diagnostic on its own.

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Covered under ⇒ PANCE Blueprint Pulmonary ⇒ Obstructive Pulmonary Diseases

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